INITIATING CLAIMS WITH OWCP TUTORIAL

                                  Initiating Claims with OWCP.

Procedures initiating claims with OWCP for an employee who has (A)

suffered a Traumatic Injury, (B) suffers from an Occupational Injury or

Disease, (C) Recurrence of Injury or Disease, and (D) Death:

Seasosn 5 podcast episode 1 explaining  how OWCP works from an OWCP Claims examiner's training. Today we are going over something I have never addressed in the podcast before…we are going to teach OWCP from OWCP Claims Examiner training material. In order to be successful with communication with an OWCP claims examiner, it is important to understand what they are trained to do, trained to look for and how to meet the eligibility requirements from their training and understanding. It helps to understand how to speak the language that the OWCP claims examiner is trained in. 

Click on the transcript for more information to source for Initiating Claims with OWCP

The podcaster is Dr. Stephen Taylor, OWCP legal consultant for Oberheiden Law Firm.  Dr. Taylor’s contact information is:

https://fedcompconsultants@protonmail.com If you need a medical provider or assistance with an OWCP /  DOL claim in Tampa, Jacksonville, Pensacola Florida, Southern Mississippi or Daphne Alabama    you can make an appointment to see Dr. Taylor, or Dr. Sullivan   at the clinic at  FWC Medical Centers or M & R Medical Centers. To make a consultation with Dr. Taylor  call the clinic at 813-215-4356 or 813-877-6900 in Tampa  go  to our website at https://fwcmedicalcenters.net/     or     https://fedcompconsultants.com/

Transcript

HI,  I’m Dr. Stephen Taylor a Federal Workers Compensation Consultant and a medical provider in Alabama & Florida who has been helping government employees with work-related injuries, disability, FERS Disability, VA disability and other types of Federal program filings for 30+ years. The name of this tutorial podcast is  Federal Workers Compensation Coffee break Podcast.  Here at this podcast we discuss all sorts of topics related to federal workers compensation, Department of Labor, OWCP, FECA ACT, FERS, longshore-maritime, DOD contractors, VA benefits over a cup of coffee. I cover these relevant topics in a short coffee break style format because in order to discuss topics that  government employees always ask for assistance on for all of these years.  I do this to assist you the government employee, you and your doctor if they want or need help or your coworkers with claim filing denials or with appropriate filing of benefit claims, disability or injured worker claims. The best part about this podcast and all of it’s tutorials for successfully navigating DOL, FERS & OWCP benefits… is that I do it all for free. All you need is a cup of coffee and a notebook.
Welcome to Season 5 of the podcast. Happy New Year. I have decided this year to dedicate explaining how OWCP works from an OWCP Claims examiner's training. Today we are going over something I have never addressed in the podcast before…we are going to teach OWCP from OWCP Claims Examiner training material. In order to be successful with communication with an OWCP claims examiner, it is important to understand what they are trained to do, trained to look for and how to meet the eligibility requirements from their training and understanding. It helps to understand how to speak the language that the OWCP claims examiner is trained in. 
So we are going to start with the Section 1 of the OWCP reference guide for the OWCP Claims examiner. Section 1 topics are the following:
1. INITIATING CLAIMS WITH OWCP
A. Traumatic Injury
B. Occupational Disease/Illness
C. Recurrence
D. Death
E. Exposure to Infectious Agents
So let's get our coffee going and dive into Season 5 Initiating Claims with OWCP.
Procedures initiating claims with OWCP for an employee who has (A)
suffered a Traumatic Injury, (B) suffers from an Occupational Injury or
Disease, (C) Recurrence of Injury or Disease, and (D) Death:
A. Traumatic Injuries
A Traumatic Injury is defined as a wound or other condition of the body
caused by external force, including stress or strain within a single day or
work shift. The injury must be identifiable by time and place of occurrence
and member of the body affected.
For Traumatic Injuries, the employee (or someone acting on his/her
behalf) must report the injury by completing a Form CA-1, “Federal
Employee’s Notice of Traumatic Injury and Claim for Continuation of
Pay/Compensation,” to his/her manager/supervisor. There is a portion of
the Form CA-1 that will need to be completed by the manager/supervisor.
The manager/supervisor should submit the completed Form CA-1 through
appropriate agency channels to insure claim is received by the OWCP
District Office as soon as possible, but no later than 10 working days after
receipt of Form CA-1 from the employee. The employee must report the
injury by completing the Form CA-1 within 30 days of the injury in order to
be eligible for Continuation of Pay (COP) entitlements and within three (3)
years to meet the FECA time limits of a claim. If the claim is not filed
within the 30-day period, and COP is not authorized, employee may file a
Form CA-7, “Claim for Compensation”, for loss of wage earnings.
However, medical documentation is required within 10 days of the injury or
the entitlement to COP will be suspended.
When warranted, the manager/supervisor will provide the injured
employee a Form CA-16, “Authorization for Examination and/or
Treatment.” Form CA-16 may be obtained through your manager
/supervisor. The CA-16 is used to provide authorization for treatment.
The manager/supervisor should complete the front of the Form CA-16
within 4 hours of the request whenever possible. If there is concern that
the facts of the injury are in dispute, the supervisor can check the
appropriate box on the Form CA-16 (6.B.2) but still provide the employee
with the form. In the event there is no time to complete the Form CA-16,
the manager/supervisor may authorize medical treatment by telephone
and then forward Form CA-16 to the medical facility within 48 hours.
Retroactive issuance of Form CA-16 is not allowed under any other
circumstances. However, Form CA-16 may not be used to authorize
treatment for Occupational Disease or Illness, without prior approval from
OWCP.
The employee has the right to choose his/her initial treating physician. A
physician is defined as a surgeon, podiatrist, dentist, clinical psychologist,
optometrist, osteopathic, practitioner, and chiropractor within the scope as
defined by state law. However, the services of chiropractors may be
reimbursed only for treatment consisting of manual manipulation of the
spine to correct a subluxation as demonstrated by X-ray to exist. A
chiropractor may also provide services in the nature of physical therapy
under the direction of a physician. The term “physician” doesn’t include
physician assistants or nurse practitioners.
B. Occupational Disease or Illness
An Occupational Disease or Illness is defined as a condition produced
in the work environment over a period longer than one (1) workday or
shift. It may result from systemic infection, repeated stress or strain,
exposure to toxins, poisons or fumes, or other continuing conditions of the
work environment. For an Occupational Disease or Illness, the
employee (or someone acting on his/her behalf) must report the disease
of illness by completing a Form CA-2, “Notice of Occupational Disease
and Claim for Compensation.” to his/her manager/supervisor.
In addition to the completed Form CA-2, the employee must provide the
completed applicable Form CA-35 a-h, “Evidence Required in Support of a
Claim for Occupational Disease,” for the disease or illness claimed. The
information requested should be submitted with the Form CA-2. If all of
the information cannot be completed at the time of submitting the Form
CA-2, additional information should be forwarded in a timely manner to
OWCP through the employer, once an OWCP Claim Number is received.
COP is not authorized and Form CA-16 may not be used to authorize
treatment for Occupational Disease or Illness, without prior approval from
OWCP. (Form CA 20, Attending Physician’s Report, can be used.)
The manager/supervisor should submit the completed Form CA-2 through
appropriate agency channels to insure claim is received by the OWCP
District Office as soon as possible but no later than 10 working days after
receipt of Form CA-2 from the employee.
C. Recurrence of an Injury or Occupational Disease or Illness
A Recurrence of disability is defined as a spontaneous return or increase
of disability due to a previous injury or occupational disease without
intervening cause, or a return or increase due to a consequential injury.
(A consequential injury is a new injury, which occurs, as a result of a work
related injury). A recurrence of a disability differs from a new injury in that
with a recurrence, no event other than the previous accounts for the
disability.
When an employee, after returning to work, is again disabled due to a
prior injury or occupational disease, the employee completes and submits
Form CA-2a, “Notice of Employee’s Recurrence of Disability and Claim for
Pay/Compensation,” to their manager/supervisor. If the recurrent disability
is related to the original injury, the employee is entitled to medical
treatment and compensation.
The employee has the burden of establishing that the current condition is
related to previous accepted injury or occupational disease condition, with
or without work stoppage. If the employee was entitled to use COP and
the 45-days of COP have not been exhausted, he/she may elect to use
the remaining days, if the 45-days have not elapsed, since first return to
duty; otherwise, the employee may elect to use sick, annual leave or leave
without pay.
D. Death Benefits
Death Claim is defined as when an employee dies because of an injury
incurred in the performance of duty. For Death Claims, the
manager/supervisor uses Form CA-6, “Official Supervisor’s Report of
Employee’s Death”, to report the work related death of an employee.
Claim for Death Benefits. The survivors of a deceased employee should
use Form CA-5, “Claim for Compensation by Widow/Widower, and/or
Children” or Form CA-5b, “Claim for Compensation by Parents, Brothers,
Sisters, Grandparents, or Grandchildren” to submit claims for death
benefits. The survivors should complete the front of the appropriate form,
while the attending physician should complete the medical report on the
reverse. This should include a copy of the death certificate, marriage
certificate, if the spouse is making the claim, a copy of any divorce or
annulment decree if the decedent or spouse were formally married and/or
copies of birth certificates of any children for whom claim is being made.
E. Exposure to Infectious Agents
FECA doesn’t provide for payment of expenses associated with simple
exposure to an infectious disease without the occurrence of a work related
injury. Infectious disease includes tuberculosis, hepatitis, and HIV
(Human Immunodeficiency Virus). Fear of exposure to an infectious agent
doesn’t entitle the worker to benefits under the FECA, since no definable
injury has occurred.
Federal Law 18 U.S.C.1922 provides that a manager/supervisor cannot refuse to
accept a Notice of Injury, Illness or Death.
If the validity of the claim is in challenged, all allegations must be reported to
OWCP by factual evidence.
Ok I think we have covered enough for one Podcast session. I think we will stop here and pick up next time on OWCP  CONDITIONS OF COVERAGE topics.
So, I want to thank you for listening and want to remind you to share this podcast with other federal workers you think would benefit from this information. Also be kind enough to leave a review on the platform you found this podcast, like or subscribe to any of the major podcast platforms or our youtube channel so others will also find this information. Also if you need an approved  medical provider for your DOL -OWCP Or Longshore case in Florida or Alabama you can  make a consultation with me to discuss your case or if you know someone if Florida or Alabama who you thinks need my help  or is  recently injured you can call the clinic at 813-215-4356 or 813-877-6900 or go  to our website at https://fedcompconsultants.com/   & https://mrtherapycenter.com/  Also if you are in  another state and you want me to assist you with claim questions or assistance for your  doctor you can email me at fedcompconsultants@protonmail.com 
Ok… I think that is enough for today…I need to warm up this coffee and get going. As usual I want to thank all of you who put on that uniform, that badge, deliver that mail, take care of our veterans and make this government run… a big thank you. I do this for free just for you…We could not do this  without all of the work all of you out there do…so this is my big  thank you. And remember if you  have an injured federal claim and you need assistance….I am  here to help!. Also remember there is power in prayer. Pray for you nation, coworkers and for God's providence in current times of unrest. 
See you next time.